How to help community workers to better target their post-test counselling in the context of rapid HIV testing with men who have sex with men (MSM)?

Published: August 31, 2010

How to help community workers to better target their post-test counselling in the context of rapid HIV testing with men who have sex with men (MSM)?

J. Otis1, M. Blais2, G. Fadel3, M.-E. Girard4, SPOT Research Team

1Université du Québec à Montréal, Chaire de Recherche du Canada en Éducation à la Santé, Montréal, Canada, 2Université du Québec à Montréal (UQAM), Sexology, Montreal, Canada, 3Coalition des Organismes Communautaires Québécois de Lutte Contre le Sida (COCQ-Sida), Montreal, Canada, 4Université du Québec à Montréal (UQAM), Chaire de Recherche du Canada en Éducation à la Santé, Montreal, Canada

Background: SPOT is a rapid HIV testing intervention carried out by community workers in community and clinical settings with the post-test counselling based on the motivational interviewing (MI) principles. The objective is to identify indicators to help community workers to better target their post-test counselling.
Methods: Between July 2009 and January 2010, 241 MSM (mean age = 35.2(±11.5)) visited SPOT in Montreal, Canada. They participated in a face-to-face structured interview on their sexual behaviours, and diverse socio-sexual factors. Four groups were identified according to scores on two items: importance of having only safer sex practices (I) and perception of having the abilities to have only safer sex practices (A): HH: High-I/High-A (48.6 %); HL: High-I/Lower-A (20.4%); LH: Lower-I/High-A (8.3%); LL: Lower-I/Lower-A (22.7%). The HL, LH and LL groups were contrasted to the HH group with multivariate multinomial logistic regression.
Results: Unprotected anal sex with VIH? and HIV+ partners in the past 3 months was reported by 22.5% of HH, 27.5% of LH, 32.7% of LL and 43.1% of HL. Compared to the HH, the LH are more likely to report a higher level of safer sex fatigue (OR:1.30; CI95%: 1.01-1.68); the LL are more likely to find it more difficult to stay safe when they are overwhelmed by sexual arousal (OR: 1.86; CI95% : 1.16-2.98) and the HL are more likely to find it more difficult to stay safe when they are overwhelmed by personal problems (OR :1.79; CI95% : 1.02-3.16) and sexual arousal (OR:1.79; CI95% : 1.08-2.95).
Conclusions: Safer sex fatigue and control over sexual affects or personal problems seem to be indicators to be used during the HIV rapid testing post-counselling depending on the men’s profile. These results are useful to prepare the training of community workers and to ensure that each MSM receives a brief intervention adapted to his needs.

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